State officials step up efforts against prescription drug abuse, targeting doctors

By Tara Kaprowy and Al Cross
Kentucky Health News

LEXINGTON ? Targeting what Gov. Steve Beshear called "drug dealers in white coats" is the goal of a new effort against prescription drug abuse in Kentucky, which is killing more Kentuckians than traffic accidents.

State Sen. Robin Webb, D-Grayson, speaks after Stumbo, Beshear and Conway at press conference.

Announced by Beshear, Attorney General Jack Conway and House Speaker Greg Stumbo at a Lexington press conference, the plan is designed to root out doctors with suspicious prescription practices and pass legislation to better track prescriptions.

Most of the effort is aimed at improving and expanding use of the Kentucky All Schedule Prescription Electronic Reporting system, which relatively few physicians use to see if patients are doctor-shopping for painkillers. An advisory board of physicians, dentists, nurses and pharmacists will work with KASPER officials and law-enforcement agencies to define acceptable prescribing practices in different medical disciplines. Suspicious activity would be reported to the respective licensing boards.

In August, Stumbo grilled the Kentucky Board of Medical Licensure about why it wasn't increasing its oversight on doctors since it had asked for the authority to analyze KASPER data. Lloyd Vest, the licensing board's general counsel, said the data were not specific enough. Stumbo said yesterday, ?The problem is how you define what over-prescribing is.? That's what the advisory board will do.

Beshear, asked how soon he would expect an enforcement action to result from the process described, he said he would ?push them to move very fast." Other boards handle licensing for dentists, nurses and pharmacists.

Beshear said he wants all physicians to be part of KASPER, especially those who prescribe scheduled narcotics such as oxycodone. Asked about the cost to doctors and patients, he said, "Kentucky will absorb whatever cost." When pressed he said, "We'll handle our part of it and I'm sure the medical profession will hold up their end of it."

Conway said only about 25 percent of physicians use KASPER, but many don't prescribe painkillers. He said the system "takes 10 or 15 seconds" to use but should be made more user-friendly. He said there is a special concern about emergency-room physicians because "a lot of people who are shopping for pills are going to emergency rooms."

Beshear said Operation UNITE, a federally funded anti-drug program in Eastern Kentucky, has received a $600,000 grant from the Appalachian Regional Commission to conduct an education program for about 1,000 physicians and drug dispensers about the dangers of prescription drug abuse and the benefits of KASPER.

Stumbo said Oklahoma recently found 80 percent of its drug overdoses were from prescription drugs and Kentucky would find "exactly the same" if it did the same study. "It's not the drug dealers that are killing our kids, it's the drug-dealing doctors," he said.

Conway said he asked a group of Eastern Kentucky students if they had taken a prescription drug for reasons not listed on the pill bottle and 75 to 80 percent raised their hands. He said the same number said prescription drugs are easy to obtain, and none said their parents lock the medicine cabinets at their homes.

Stumbo, a Prestonsburg lawyer who preceded Conway as attorney general, said the trend reports from KASPER have shown pill abuse leveling off in Eastern Kentucky but rising in places outside the region, and gave Marion County and the Jackson Purchase as examples.

Beshear and Conway are running for second terms in the Nov. 8 election, but Stumbo said the effort is non-partisan and Republican Sens. Jimmy Higdon of Lebanon and Robert Stivers of Manchester are also working on it. They did not attend the press conference, but Higdon said in an interview that he will pre-file a bill require pain clinics to be appropriately licensed and run by physicians who pass background checks.

Also invited but not present was Sen. Tom Jensen, R-London, who is exploring the possibility of again introducing a bill that would make pseudoephedrine, the key ingredient for making methamphetamine, available only by prescription. Beshear, who declined to take a position on that, said he is "committed to finding an answer" to the problem but it does not have the sort of consensus that the prescription drug-abuse issue has.

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